The second part of the study involved determining the availability of basic trauma care at the ECFs where a given patient could have been taken on his way to TCs.
The first major observation was that there is an apparently poor mix of services, with a very low availability of basic emergency obstetric care (BEmOC) units and a relatively high availability of comprehensive emergency obstetric care (CEmOC) units.
The major supply side constraints that contribute to maternal death are shortages of skilled midwives, weak referral systems at health centres, and inadequate availability of basic and comprehensive emergency obstetric and neonatal care equipment.
Quality of care was assessed in terms of availability of basic resources (principally equipment and drugs) and audit of case records for documentation of patient assessment and treatment at admission.
Limited availability of basic supplies was felt to be a major cause of substandard obstetric care in health centers and hospital.
The characteristics required to be fulfilled relate to the availability of basic medico-technological equipment as well as to the orientation towards primary care and the community.
Better routine maternal and newborn care, including the promotion of breast feeding and the provision of adequate services including availability of basic equipment will help," UNICEF and MGA Water LLC representatives said.
Before launching the initiative, we were asked to perform a baseline assessment of the current availability of basic EmOC in the Central Province of Zambia, as no previous study had investigated the capacity of the Central Province health care system to meet existing standards for basic EmOC.
This questionnaire asked about the availability of basic items required for management of circulation and shock, airway insufficiency, and spinal injury, for diagnosis and monitoring, safety for health care personnel, pain control, and medicines.
None of the inpatient facilities had consistent availability of all seven components of a basic care package for severe malaria management (parenteral quinine, intravenous fluids, 50% dextrose, blood for transfusion, transfusion sets, IV giving sets, syringes).
